Deaton, Tracy A

Deaton, Tracy A is an individual health care provider with primary practice located at 3301 Cranberry Blvd , Weston WI 54476-5216. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Deaton, Tracy A can be contacted via phone (715) 393-3900.

Contact Information

Primary practice address
3301 Cranberry Blvd Weston WI 54476-5216
Phone: (715) 393-3900
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 1624 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1624 Wisconsin

Profile Details

NPI number 1154382521
LBN Legal business name Deaton, Tracy A
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2006
Last updated Nov 17th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154382521 NPPES
Wisconsin MEDICAID APPR

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